| Diagnostic and Therapeutic Efficacy of Endoscopic Retrograde
Cholangiopancreatography in Children |
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Kyung Mo Kim1, Ho Soon Choi1, Sung Koo Lee1, Myung Hwan Kim1, Chong Hyun Yoon2, Dong Myung Lee3 |
1Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea
2Department of Diagnostic Radiology, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea
3Department of Anesthesiology, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea |
| 소아에서 내시경적 역행성 담도췌관조영술의 진단적 및 치료적 유용성 |
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김경모1, 최호순1, 이성구1, 김명환1, 윤종현2, 이동명3 |
1울산대학교 의과대학 서울중앙병원 소아과
2울산대학교 의과대학 서울중앙병원 방사선과
3울산대학교 의과대학 서울중앙병원 마취과 |
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| Abstract |
Purpose
: Endoscopic retrograde cholangiopancreatography(ERCP) may provide more definite
diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected
disorders of the pancreas and biliary tract. But the reports about the ERCP in children are rare, so
this study is conducted to evaluate the indication, efficacy and safety of the ERCP in children.
Methods
: Twenty nine ERCPs in 19 children were included in this study from July, 1994 to Dec,
1996. The children were nine boys and ten girls and their mean age was 6.9 years old(24
months-14 years). The examination was performed in 16 children under general anesthesia while
the other 3 adolescent under conscious sedation with Olympus JF or JF1T duodenoscope. We
evaluated the indication, efficacy and complication of the ERCPs.
Results
: All cannulations were successful except one and endoscopic sphincterotomy (EST) was
done in 12 children. Among 19 children, we could confirm the clinical diagnosis in 6, add the
additional information in 5, revise the diagnosis in 4(operation guidance in 3), but give no diagnosis
in 4 even after ERCP. The diagnosis after ERCPs are choledochol cyst(4), choledochocele(1), bile
duct stricture(1), GB and CBD stone(1), pancreatitis with biliary sludge(5), chronic pancreatitis(2)
and pancreatic fistula(1). We could achieve therapeutic goal in 8 children after therapeutic ERCP in
11 children. As complications of ERCP, pancreatitis developed in 2 children, moderate delayed
hemorrhages requiring transfusion in 2, retroduodenal perforation in 1 and cholangitis in 1 child. No
fatality was observed and all complications improved after supportive cares. Most of the
complications developed after EST.
Conclusions
: All ERCPs were successful, although most of them were done under general
anesthesia. In this study we could conclude that ERCP may provide more definite diagnosis,
preoperative guidance, and endoscopic therapy in many children with known or suspected disorders
of the pancreas and biliary tract. But special care should be paid especially after EST. |
| Key Words:
Endoscopic retrograde cholangiopancreatography, Therapeutic ERCP, Child, Indication, Complication |
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